Hand hygiene is the single most important practice for preventing the spread of infections in healthcare. Germs can easily be transmitted via hands, so proper hand hygiene is critical. This involves both handwashing with soap and water and using alcohol-based hand sanitizers. Remember, even with gloves, hand hygiene is still necessary before and after gloving and after removing gloves.

Example: Think about drawing blood from a patient. You've touched the patient's skin to locate the vein, touched the equipment, and maybe adjusted your PPE. All these actions increase the risk of contamination. Therefore, meticulous hand hygiene is essential at multiple points.

Handwashing should be performed when hands are visibly soiled, after using the restroom, and before eating. Here's the recommended procedure:

1. Wet hands: Thoroughly wet hands with warm water.
2. Apply soap: Apply enough soap to cover all hand surfaces.
3. Lather and scrub: Rub hands vigorously for at least 20 seconds. This includes scrubbing all surfaces of the hands and fingers, including under the nails.
4. Rinse: Rinse hands thoroughly under running water.
5. Dry: Dry hands with a clean paper towel. Use the paper towel to turn off the faucet.

Example: Imagine your hands are covered in invisible germs. The friction from scrubbing for 20 seconds is like a 'scrub-a-dub-dub' for your hands, dislodging and removing these invisible invaders. Be sure to dry completely to prevent recontamination.

Alcohol-based hand sanitizers are effective when hands are not visibly soiled. Use a sufficient amount to cover all surfaces of your hands. Here’s the process:

1. Apply: Dispense the product onto the palm of one hand.
2. Rub: Rub hands together, covering all surfaces of your hands and fingers, including the back of your hands and between your fingers.
3. Continue rubbing: Continue rubbing until your hands are dry. This typically takes around 20 seconds.

Example: Think of the sanitizer as a disinfectant that needs complete contact with the germs. Rubbing until dry ensures all areas of your hands have been exposed to the sanitizer.

The order of donning PPE is important to protect yourself and prevent contamination of clean items. The common order is:

1. Hand Hygiene: Perform hand hygiene before putting on any PPE.
2. Gown: Put on the gown and tie it securely in the back (or secure any other fastenings).
3. Mask or Respirator: Put on the mask or respirator, ensuring it covers your nose and mouth snugly. Secure the straps and perform a fit check (if applicable).
4. Eye Protection: Put on eye protection (goggles or face shield), if required. Ensure it fits snugly.
5. Gloves: Put on gloves, pulling them over the cuffs of the gown.

Example: Imagine preparing to draw blood from a patient with a known communicable disease. You would follow the donning procedure to create a protective barrier between yourself and the patient’s potentially infectious bodily fluids.

The order of doffing PPE is equally critical to prevent the spread of contamination. This order ensures that the most contaminated items are removed last. Here's the general process:

1. Gloves: Grasp the outside of one glove with the opposite gloved hand, peel it off, turning it inside out. Hold the removed glove in the gloved hand.
2. Gloves (Second Glove): Slide fingers of the ungloved hand under the remaining glove, peel it off over the first glove, creating a 'glove-in-glove' ball. Discard the gloves immediately into a designated waste container.
3. Hand Hygiene: Perform hand hygiene immediately after removing gloves.
4. Eye Protection: Remove eye protection (goggles or face shield). If reusable, clean and disinfect. If disposable, discard into appropriate waste.
5. Gown: Untie the gown (or unsnap) and remove it, rolling it away from your body. Dispose of the gown into a designated waste container.

6. Hand Hygiene: Perform hand hygiene after removing the gown.

7. Mask: Remove the mask or respirator by touching only the straps or ear loops. Do NOT touch the front of the mask. Dispose of the mask into a designated waste container.

8. Hand Hygiene: Perform hand hygiene after removing the mask.

Example: You have just finished drawing blood. The gloves are considered the most contaminated item. By removing the gloves first and performing hand hygiene, you protect yourself from any substances that may have landed on your gloves. Careful doffing protects you and prevents further contamination.

Handwashing with soap and water is required when hands are visibly dirty or soiled. Alcohol-based hand sanitizers should be used when hands are not visibly dirty and for routine hand hygiene. Both are critical components of infection control, so knowing when to use each is paramount.

Example: If you've just handled a specimen with blood on the outside of the vial, you must wash your hands with soap and water. If you are entering a patient room, and your hands aren’t visibly soiled, you can use hand sanitizer.